One Nation, Under Cleaner Skies

The EPA announced new rules to cut smog in Eastern states this week, and the familiar players lined up toe to toe on their well-worn battle lines. The rules are expensive and kill jobs! The rules are efficient and save lives! I’m rolling my eyes at how the familiar arguments play out over and over again.

Have you heard it too? The electric companies and advocates for leaner government rail on the costs. The environmental groups (and the EPA and doctors and scientists and public health groups) say that the benefits are larger, and the rules will save money.

Looked at in the right light, both views are right. At the risk of making you roll your eyes at the familiar conflict, let’s take another look at why.

Yes, there are the costs to implementing EPA’s new smog rules. These costs include things like purchasing new equipment, maintenance of the equipment, retrofitting plants, taking plants off-line for that purpose, hiring specialized workers, perhaps purchasing more expensive and less-polluting coal, and shuttering profitable old plants without pollution control technology. The people who work at those old plants would be laid off. And the utility companies would shoulder costs totaling in the billions.

EPA’s proposed pollution limits for SO2 and NOx will annually save more than 10,000 lives and prevent more than 70,000 asthma attacks by 2014, when compared with the pollution limits finalized by the Bush administration. The monetary value of the additional, extensive health protections for our nation will exceed $85 billion annually.

Who is hurt by the rules? Utility companies, utility workers, coal miners and the supporting industries, as well as electricity consumers who (according opponents of the rules) would see an increase in the cost of electricity.

Who is helped by the rules? Children, the elderly, pregnant women, newborn babies, those with heart disease and respiratory disease, people who would be paying for less healthcare under the new rules (because they and their families would be healthier), recreational and subsistence fishers who could safely eat more of what they catch, and the companies that produce scrubbers and other clean-up technology for utility smoke-stacks.

The thing is, these groups are not mutually exclusive. Many people who would be hurt by the rules in one aspect of their lives would be helped by the rules in another. So it’s not just that the rules hurt some people and protect others. It’s that the rules hurt and protect the same people at the same time. The question is just how you balance those hurts and those helps.

The people who work at coal plants and utility companies get pregnant, have children, and pay for healthcare. But the costs of the EPA rules are up-front costs paid by companies in order comply with a rule from above. Meanwhile, the benefits are not immediate, explicit, or obvious, at least not to the individual corporate shareholder or utility worker. They require a special lens. A public health lens.

Public health addresses the health of populations. Public health workers are not necessarily providing hands-on, clinical care (though many also do so). Instead they take a step back from the clinic to look at the population, whether that is defined as the neighborhood, the city, the state, or the world. Instead of prescribing asthma inhalers to ease the breathing symptoms of patients in clinics, public health workers think about the patterns of asthma inhaler prescriptions. Or they wonder when the most strokes happen. Or ask what the rates of lung cancer look like over time. Or what environmental factors might influence heart attacks.

Public health workers are constantly asking, what is the bigger picture? And electric utilities are constantly asking, what is the bottom line?

And you and me, too, ask these same questions of ourselves as individuals over and over throughout the day, in the grocery line, creating a strategy for our work projects, dealing with a toddler’s tantrum, researching the local school system. So we know what it’s like to do something that feels like it harms one part of us even as it helps another aspect of our lives. We are all one person.

Just as, from the public health lens, we are all one people. We suffer diseases and recessions as a population. So even if the EPA’s proposed rules were going to kill jobs and slow the economy and jack up electricity prices (and I personally don’t believe they will) – even if they’ll do all these things, we need to remember that they will also help those very same people that they hurt.